How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,365.16 | Professional | None | $3,388.44 | $3,388.44 | $4,365.16 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,511.89 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $338.84 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $5,011.87 | Professional | None | $2,238.72 | $3,019.95 | $5,011.87 |
BCBS Rhode Island Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $2,089.30 Typical High $3,467.37 | Professional | 54 · Surgery only | $1,479.11 | $2,089.30 | $3,467.37 |
BCBS Rhode Island Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $229.09 Typical High $380.19 | Professional | 55 · Aftercare only | $162.18 | $229.09 | $380.19 |
BCBS Rhode Island Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $204.17 Typical High $338.84 | Professional | 56 · Pre-op care only | $141.25 | $204.17 | $338.84 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,513.56 Typical High $6,456.54 | Facility | None | $426.58 | $1,513.56 | $6,456.54 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,691.53 | $4,365.16 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,344.23 | $2,344.23 |
Where Rhode Island sits
The same service costs 5.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Rhode Island· 26th of 51
$3,020
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.